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On the surface, it may seem like PTSD and Complex PTSD are none too dissimilar. They both come as the result of something deeply traumatic; they cause flashbacks, nightmares, and insomnia; and, they can make people live in fear even when they are safe. But, at the very heart of C-PTSD - what causes it, how it manifests internally, its lifelong effects (including medically), and its ability to reshape a person's entire outlook on life - is what makes it considerably different. Therapy can help!

What is PTSD?

Posttraumatic stress disorder (PTSD) may develop in some people after extremely traumatic events, such as combat, sexual violence, a terrorist attack, crime, an accident, or a natural disaster. In these cases, the individual was exposed to actual or threatened death or serious injury. These types of traumas are typically "short-lived" even though the person may experience effects for long after the event occurred.

People with PTSD may relive the trauma in painful recollections, flashbacks, or recurrent dreams or nightmares; avoid activities or places that recall the traumatic event; or experience physiological arousal, leading to symptoms such as an exaggerated startle response, disturbed sleep, difficulty in concentrating or remembering, and guilt about surviving the trauma when others did not. (

Sometimes dissociation may occur as a symptom, which is the brain's way of protecting itself from material that it perceives to be too painful to experience. Your therapist can help if you are experiencing this.

What is Complex PTSD, or C-PTSD?

C-PTSD describes the results of ongoing, inescapable, relational trauma. Unlike Post-Traumatic Stress Disorder (PTSD), Complex PTSD typically involves being hurt by another person. We call this relational trauma and it most often involves abuse or neglect by a parent or primary caregiver during development in childhood. These hurts are ongoing, repeated, and often involving a betrayal, abandonment, and loss of safety.

Humans require safe people, safe places, and safe things during childhood and adolescence in order for healthy brain development to take place. Many adult survivors of complex trauma, having experienced this loss of safety, had no agency over themselves or their environment during critical times in brain development for extended periods of time. This loss of agency during their early years stunted their growth, depriving them of the opportunity to create the lives they deserved, and has ultimately left many stripped of their sense of worth and sense of self. Without the ability to understand what has happened, young survivors grow up to be adults who live in the same constant state of hypervigilance and suffering, even after escaping physical danger. Many spend years in counseling without real results because they haven't identified their experiences as trauma.

Adult survivors of complex trauma often experience amnesia, alienation, chronic mistrust, chronic physical pain, re-victimization, debilitating flashbacks, nightmares, body memories, anxiety, dissociation, trouble with regulating volatile emotions, severe depression, toxic shame, auto-immune disease, along with other deeply distressing and potentially life-altering symptoms. Individuals with CPTSD will often go on to receive a diagnosis of Borderline Personality Disorder, Bipolar, Depression, OCD, Eating Disorders etc.

Examples of childhood experiences that can cause C-PTSD:

  • Growing up in a household where someone was addicted, hoarding, exhibiting OCD behaviors or otherwise mentally ill

  • As a child, being forced to meet the emotional or instrumental needs of a parent or sibling on a regular basis. This is called parentification or covert incest.

  • Your parents used the "silent treatment", made you the mediator in their fights, etc

  • Overly-controlling parents

  • Your parents were emotionally unavailable to you

  • You became enmeshed, or overly-involved with a parent

  • etc . . .

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